Sildenafil: Benefits, Uses, Dosage, and More

Sildenafil: Benefits, Uses, Dosage and More

Erectile dysfunction is an unfortunate part of many people’s lives across the globe. Whether it is age-induced, physiological, or psychological, erectile dysfunction can place unneeded stress on the lives of men. The sexual response process is incredibly complex and involves many moving parts that need to occur in unison to properly work.

A deficit in any part of the cycle can lead to erectile dysfunction and other sexual dysfunctions. These issues can compound with other factors that could place strain on your social and mental wellbeing. Finding a treatment option that works for you could mean the difference between a happy and healthy life and one clouded in turmoil.

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Elite HRT

Written by Elite HRT
on June 09, 2021

Medically reviewed by

Camille Frecking, Regulatory Affairs Specialist, MEDICAL ADVISOR


Before the 1990s, erectile dysfunction was seen as a complex disorder that required complex treatments. Penile injections, psychological therapy, and even hormone therapy were the go-to treatment. While these treatments could help men attain an erection, none of the options provided immediate and convenient relief to their situation. 

In 1998, the pharmaceutical company Pfizer first introduced the now widely popular drug Viagra. 

In the past 23 years, Viagra has become more widely available and renowned as a quick and easy treatment for men with difficulty attaining or maintaining an erection. Viagra’s active ingredient is sildenafil and is now widely available in both its original branded blue pill form as well as generic. 

With such a wide utilization of this ED drug, it is only reasonable to be curious about it. Below is a closer look at sildenafil. Knowing its benefits, uses, dosage, and limitations can make you more informed about this widely prescribed drug and help in your decision to seek treatment. 

Finding an ED treatment that works best for you and your situation is key to getting back your quality of life without having to make large compromises. 

How Is an Erection Attained?

As a young adult or a person unaffected by erectile dysfunction, there is most likely very little thought that goes into the process of attaining an erection. This process seemingly just occurs on its own and it is easy to take it for granted until something isn’t quite right. While it can initially be frustrating when ED symptoms are experienced for the first time, understanding the underlying process of how an erection is achieved can help you understand the complex nature of the sexual response and feel less defeated. 

The process of attaining an erection involves the mind, cardiovascular system, and nervous system to occur. All of these work simultaneously to increase blood flow to the penis which yields an erection. 

At a molecular level, nitric oxide is the beginning of the chemical cascade that signals for blood vessel dilation, increase in blood flow, and ultimately an erection. Nitric oxide is released in the structure known as the corpus cavernosum when you become aroused. Nitric oxide levels remain elevated until resolution where it along with all of the other chemical messengers required for an erection are degraded by enzymes known as specific phosphodiesterase type V (PDE5). The process of degradation of these chemical messengers is important in the mechanism of action for an erection to resolve and the surrounding smooth muscle relaxation. 

Common Causes Erectile Dysfunction

Erectile dysfunction is a complex and oftentimes multi-faceted dysfunction that requires healthcare providers to look at their patients in a holistic manner to understand the root cause of their ED. Below is a look at two common causes of ED. 

Circulatory Health

The circulatory system plays a huge role in the ability to get and maintain an erection. The flow of blood to the tissues of the penis is what allows for the rigidity of an erection. Essentially blood is directed to the hollow-like structure known as the corpus cavernosum that fills with blood. The pressure and volume of blood directed to the corpus cavernosum is what enables rigidity. 

Medical conditions that affect your cardiovascular health like pulmonary hypertension (a type of high blood pressure), angina (chest pain), hypotension (low blood pressure), and history of heart attack or any other heart problem can directly impact your sexual health and the ability for sexual stimulation. Specifically, as you can see, conditions that decrease the efficiency of blood flow can result in ED. The less blood that can reach the appropriate structure, the harder it becomes to attain or maintain an erection hard enough for sexual activity. 

Low Libido

Low libido is often a large contributing factor to ED. This cause of ED impacts your body’s ability to mentally achieve a state of arousal which is essential when trying to attain an erection. 

Low libido can be caused by several things. This includes stress, depression, some medicines, and even low hormone counts. As men age, the amount of testosterone and HGH can see drastic falls. While diminishing hormone levels are correlated with aging, it doesn’t mean you have to follow suit. 

Negative symptoms of aging like decreased libido can be helped by the supplementation of hormones or peptides in hormone replacement therapy. If deemed necessary by the medical advice of a licensed physician, specialized hormone clinics like Elite HRT can help develop a hormone treatment plan that fits you and your needs. 

How Does Sildenafil Work in the Body?

Sildenafil is a unique drug that impacts the circulatory system in a very specific manner. Many drugs that interact with the circulatory system have system-wide effects. An example of this would be blood pressure medications which cause an alteration in your blood pressure throughout your body. Sildenafil, on the other hand, has a very specific mode of action, and for the most part, only affects the cells within the corpus cavernosum

Sildenafil works by temporarily inhibiting the action of the enzyme PDE5. As discussed previously, PDE5 is an enzyme that degrades the chemical messengers that make an erection possible through the dilation of blood vessels. While under normal circumstances PDE5 is unproblematic, temporarily decreasing its effectiveness can give a helping hand to those that have ED. 

In short, sildenafil amplifies the effect of nitric oxide by decreasing the derogatory effects of PDE5. An increase in the chemical messengers found in the corpus cavernosum greatly increases the chance of attaining and maintaining an erection.

Dosage of Sildenafil

Sildenafil comes in a variety of different dosages. While many forms of ED are caused by a disruption somewhere in the sexual response cycle, they often vary significantly from person to person. 

The typical dosage range for sildenafil is anywhere from 25mg to 100mg. 

The goal of prescribing sildenafil is to find the minimal amount of the drug that provides you with the most desirable effects. Increasing the dose can increase the chances of experiencing adverse side effects so it is in your best interest to find the minimal dose that allows you to regain your sex life. 

Usually, people are first prescribed a middle ground dosage of 50mg. Depending on the results of this first prescription, a physician can decrease or increase the dosage to ensure that the patient is getting what they need. 

Benefits of Sildenafil

Sildenafil and other PDE5 inhibiting drugs have a large benefit over other ED treatments. The largest of which is that it is convenient and not very invasive. Simply taking a pill before you plan to be intimate is much less involved than other methods like penile injections. 

Limitations of Sildenafil

While sildenafil is ideal for those that have trouble attaining an erection physically, it isn’t necessarily a solution for those with a lowered libido. 

A decreased desire for sex can be driven by many factors, including mental turmoil and low hormone levels, and mey require therapy on top of medical help. A diminished desire and drive for sex may hinder the effectiveness of PDE5 inhibitors as your body may be able to attain an erection, but your mind is not in it. 

Talking with your care provider throughout treatments is ideal as a physician can tailor their approach to get you the best results. For some it is as simple as taking a little blue pill, while for others it is a combination of living a healthy lifestyle and taking supplements, getting counseling, undergoing hormone replacement therapy, and taking sildenafil. 

Every man is different and all of the ED treatments available today can help to get you back to a happy and healthy sex life. 


In summary, sildenafil is a drug that is classified as a PDE5 inhibitor. Created in the late 1990s, sildenafil changed the ED treatment landscape. Millions of men across the globe in the past 23 years have benefited from the convenience and affordability that a small ED pill can bring to their life. Simply take a small pill and their inability to attain an erection seems to disappear. 

By blocking the activity indicative of the resolution stage, sildenafil can enhance the body’s chemical cascade of messengers to attain an erection easier. 

While beneficial for ED caused by physical limitation, sildenafil is not always the answer. With a plethora of other PDE5 inhibitors and other treatments available, ED has never been more treatable than it is now. 


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